可逆性后部脑病综合征的临床和影像学特点  

Clinical and neuroimaging features of posterior reversible encephalopathy syndrome

作　　者：李晴[1] 彭福华[1] 胡学强[1] 邱伟[1] 

机构地区：[1]中山大学附属第三医院神经科,广州510630

出　　处：《中国神经精神疾病杂志》2010年第4期197-200,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨可逆性后部脑病综合征的临床表现和影像学特点。方法回顾性分析3例PRES的临床和影像学资料。结果本组病例继发于系统性红斑狼疮、显微镜下多发性血管炎、病毒性脑膜炎各1例,其临床表现主要有头痛、意识障碍、痫性发作、视力受损和血压升高。3例均行头颅MRI检查,显示以双侧顶、枕叶为主的皮层和/或皮层下T1低或等信号,T2及FLAIR高信号。治疗后3例于2周内临床症状均明显好转,1例于起病后14d复查MRI基本恢复正常。结论PRES具有特征性的临床表现和影像学特点,提高对该病认识,早期诊断和适当治疗有助于恢复,避免疾病进展和发生不可逆的脑损伤。Objective To investigate the clinical and neuroimaging features in patients with posterior reversible encephalopathy syndrome （PRES）.Methods Three cases of PRES were retrospectively analyzed.Results Among these cases,one was secondary to systemic lupus erythematosus;other was caused by microscopic vasculitis;and the third resulted from viral meningitis.The main manifestations include headaches,conscious disturbance,visual disorder,hypertension,and seizures.The brain magnetic resonance imaging showed mutifocal hyperintense signals of bilateral cortical and subcortical regions of parietal-occipital lobes as well as other areas on T2-weighted and fluid attenuated inversion sequence.Clinical condition improved in all patients at 2 weeks following antihypertensive and anhydration therapy and MRI abnormalities were completely reversed in one case at 14 days after the onset of PRES.Conclusions PRES has characteristic clinical and neuroradiological features.Early diagnosis and treatment may be essential to prevent progression to irreversible brain damage.

关 键 词：可逆性后部脑病综合征 临床特点 核磁共振 

分 类 号：R747.9[医药卫生—神经病学与精神病学]